AFTER THE PROCEDURE
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Keep the plaster/bandage dry for two days. You can then remove it. You can also shower normally afterward. Do not take a bath, swim, or use a sauna, as the treated area will become too soft. If adhesive strips were used, leave them on for as long as possible. They will fall off on their own, and it's okay if they get wet. If the ends come loose and curl, cut them off. |
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With skin grafts, the entire area is covered for a longer period of time. In this case, you should not remove the bandage yourself. |
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The procedure site will feel stiff and numb. This may last for several hours. |
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External non-dissolving stitches must be removed after an agreed-upon period. Sometimes this is after 5-7 days, sometimes they need to remain in place for two weeks. Stitches can be removed by your GP or at the Dermatology outpatient clinic. For complex sutures, you will need to return to the outpatient clinic for stitch removal and wound inspection. |
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Depending on the size and location of the wound, we recommend taking it easy for two weeks: no heavy lifting, sports, or similar activities. Also be careful when dressing, undressing, and shaving. |
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You'll usually have little to no pain after the procedure. If you do experience any pain, it's best to take paracetamol (500 mg four to six times a day). Do not use aspirin, ibuprofen, or similar painkillers that thin the blood unless prescribed by us. Increasing pain can be a sign of an infection (see complications). |
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Bruising (contusions) may occur in the first few days. These will disappear on their own. |
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The skin heals with scar formation. The scars will be more beautiful in some people than in others. For some, after a few months, they'll be completely invisible. |
COMPLICATIONSMost of the time, everything goes well, but complications can arise with any procedure. Read below to find out what could go wrong and what you should do if you do so. Contact the department if necessary.Opening of the woundA wound can partially or completely dehisce if the stitches break, come loose, or tear through the skin. This is especially likely to happen with thin, fragile skin (in old age or after using prednisone). This isn't a big deal; the wound will eventually heal, it just takes a little longer. No action is needed for loose stitches. It's not customary to re-stitch in such a situation. Dehiscence can be prevented by applying additional reinforcements such as special adhesive strips (dovetails). And you can help yourself by taking it easy and avoiding movements that put extra stress on the wound.Post-operative bleedingAfter a procedure, post-operative bleeding can occur. This is especially common in people taking blood thinners. Post-operative bleeding often only starts a few hours after the procedure, once the anesthetic has worn off and you're already back home. The anesthetic contains a substance that constricts the blood vessels (adrenaline) to reduce bleeding. After a few hours, this substance wears off, and the blood vessels reopen. In the event of post-operative bleeding, apply pressure to the wound with a clean bandage or clean tissue for at least 20 minutes continuously (check the time with a clock). The bleeding usually stops after this time. If the bleeding doesn't stop, contact the hospital, your GP, or the emergency room. Re-bandaging and applying a pressure bandage often help. Sometimes further measures are necessary, such as reopening the wound and tying off blood vessels. Some people return to work immediately after a procedure. This may seem daunting, but it's very unwise.Nerve damageSmall nerve branches run throughout the skin, and these can be severed during surgery. The nerve branches that provide sensation to the skin are very thin and run very superficially. These are often severed, resulting in prolonged numbness and loss of sensation on one side of the scar (weeks to months). In addition to sensory nerves, nerves that control muscles can also be damaged. This rarely happens because they lie much deeper. It can occur with large and dangerous skin tumors, such as squamous cell carcinomas and melanomas, where a large safety margin must be maintained for healthy skin. In the face, it can occur with the facial nerve that supplies the eyelids and the corners of the mouth. Surgery is always performed with caution, but sometimes the tumors are deep and located precisely where these nerves run. Damage can cause an eyelid or a corner of the mouth to droop, and this sometimes does not heal completely, or only after many months.Infection of the wound.Bacteria can enter the wound. Signs of a wound infection include pain, redness, and swelling, sometimes pus oozing from the wound, a foul odor, or fever. In that case, contact the department. Antibiotics will often be prescribed. Sometimes antibiotics are prescribed preventatively, for example, in patients with a weakened immune system or for surgeries involving areas prone to infection (e.g., ears, groin, armpits).Failure of transplants to takeFor large wounds, a piece of skin from another location can be transferred to the wound, or pulled towards it. The goal is for this to heal neatly. Sometimes a piece of transplanted skin doesn't take root, or not at all. A section then becomes blue, crusty, or black. In that case, it's best to wait for spontaneous healing. Every wound eventually heals.Ugly scarScars sometimes become beautiful and barely visible, and sometimes they become unsightly. This varies by procedure, location, and person. Scars on the chest and back often don't look as good, likely because the skin is constantly moving with breathing. It's important not to judge a scar too quickly. The body naturally remodels and smooths scars, but this can take up to a year.
Permanently unsightly scars can be corrected at a later stage. Some patients suffer from excessive scar formation, called keloids or scar hypertrophy. They develop thickened scars, and unfortunately, there's little that can be done about this.TO ASK ?In the event of an infection (increasing redness, pain, pus discharge, fever) or persistent postoperative bleeding despite 20 minutes of continuous pressure, always contact the dermatology outpatient clinic at 020-5662530 for consultation. Outside office hours, for emergencies, please contact the dermatologist on duty via the switchboard at 020-5669111, or the AMC emergency department at 020-5662222.
If you live far from the AMC, it is wiser to contact a GP out-of-hours clinic or emergency department in your area for acute problems such as postoperative bleeding. |
